Tuesday, January 31, 2023

Have you ever thought about taking your child to your internist instead of the pediatrician? Probably not, because your Pediatrician is someone who specializes in the growth and development of children.

Just like your pediatrician, a pediatric dentist, is a doctor that has 2 to 3 years of specialty training beyond dental school. A pediatric dentist also specializes in growth and development and how to deal with and engage the child psyche. This specialist has the tools necessary to treat special needs patients, and the hospital experience to provide care in different settings when necessary.

Pediatric Dentistry is mostly about prevention. The earlier you start, the greater the chances that you will have a strong, healthy, caries-free, life-time smile. An expectant mother should seek a Pediatric Dentist to receive prenatal recommendations of what to expect and how to manage feeding, suckling, teething, and oral hygiene. You want to prevent developing nursing caries. Here are a few points to keep in mind as your child grows:

• The American Academy of Pediatric Dentistry and the American Dental Association recommend that a child see a dentist by the age of one. At that time there are usually 8 teeth in the mouth. Parents should make sure that they have the information necessary to protect these teeth and the developing bone structures. By the age of 2.5 or 3, all 20 primary teeth have erupted. At this time fluoride toothpaste should be introduced, but it is necessary that the child be comfortable rinsing and spitting. Toothpaste should not be swallowed.

• If you do not live in a community that has water fluoridation, your pediatrician may have given your child a multivitamin containing fluoride. If not, your pediatric dentist can prescribe a fluoride supplement. Children from the ages of 6 months through 16 should receive fluoride supplements if it is not in their drinking water. The surgeon general has released a statement in April discussing the many benefits of fluoride. It is available online at ADA.org

• Unless there is a problem, the first set of radiographs is taken when a child is 5. The radiographs consist of a film to view if there are any extra teeth that prevent normal eruption of the anterior permanent dentition and two films taken to check for cavities between the posterior teeth.

• Permanent teeth can start growing into the mouth as early as 4 years old, but the average age is 6. This is why the first permanent molars that grow in behind the baby teeth are called 6 year molars. Sometimes you see two rows of teeth in the mandibular anterior part of the mouth. That happens because the permanent tooth buds develop in the bone behind the roots of the primary teeth. Those roots may not have resorbed enough for the baby teeth to exfoliate before the eruption of the permanent teeth that will take their place.

• Sealants are a protective coating applied to the occlusal or top surface of the tooth. These are usually recommended when the six year molars are fully erupted. One of the reasons that most adults have fillings on these molars or have lost these teeth is because they grow in so early, when as a child they lacked the knowledge and dexterity to brush properly.

• At age 7, a child should be evaluated by an orthodontist. It is important to check and compare the growth of the maxilla and mandible as they relate to one another. There are techniques that can be used to guide the growth and prevent surgery in the future. The dentition is also evaluated at this time since the child has mixed permanent and primary teeth. Space maintainers can be used to preserve room and to prevent extraction of permanent teeth later on. Bone expanders can also be used to create more space for the adult dentition. Since children’s bones are so malleable at this young age, this is possible without discomfort.

• Trauma to the oral cavity should be evaluated promptly for the effects on the permanent dentition. Primary teeth are not replanted, but permanent teeth should be in a timely manner.

• Between the ages of 12 and 16 most of the permanent dentition should have erupted, except for the third molars. They can appear between ages 18 and 25. These teeth are often missing, impacted, and often cause misery when they erupt. These should be monitored radiographically.

Dr. Martha Miqueo is an Orthodontist and Pediatric Dentist. She is a graduate of New York University College of Dentistry and has been in practice for 20 years. She has three children ranging in ages from 11 to 18 and lives in Tenafly with her family.

Orthodontic Specialty #06134

Pediatric Specialty #06248

By Martha Miqueo, DDS

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